1. Head Lice

2. Head Lice – A Lousy Problem Remember to keep things in perspective. Although head lice are a nuisance, they do not carry disease.

3. The school nurse has 4 goals Prevent / contain the spread of lice in the school setting Educate parents to prevent, recognize and treat head lice Minimize school absence Prevent children from over exposure to potentially hazardous chemicals

4. What are Head Lice? Insects that live and reproduce on your head Head lice feed on blood from your scalp Head Lice are a common nuisance, and are not considered a health hazard

5. Life Cycle Eggs Nymphs Adults

6. Transmission Person-to-person transmission (direct contact) Must transmit live adult louse

7. Contracting Head Lice Head lice crawl quickly from head to head when in close contact. NIT/ eggs do NOT transmit lice Cannot fly, jump, or hop Live adult lice can be transferred when personal objects are shared: combs, brushes, hats

8. Who can get Head Lice? Anyone who has close head-to-head contact with someone who has head lice More common among preschool and elementary school-aged children and their families Personal hygiene or cleanliness in the home or school has nothing to do with getting head lice Head lice cannot live and reproduce on animals, only on humans.

9. What to look for on the child’s head Evidence of scratching Live crawling adult lice Eggs or Nits attached to the hair shaft Nymphs ( may look like pepper on scalp )

10. What do they look like? Adult head lice –Tiny wingless brown insects; size of a sesame seed –Live for about 20-25days –If a louse crawls off of a head, it dies within 24 hours of being off a host

11. Live Louse transparent brown

12. What do they look like? Nymphs –Are baby head lice –Smaller than adult head lice –Mature in about 1 week Nits (eggs) –Tiny specks; about the size of a knot in thread –Firmly attached to the hair close to the scalp –Nits are usually found on the hair behind the ears, at the back of the neck, and above the forehead. –Do not mistake for dandruff, which can be easily blown off.

13. FACTS Only live bugs can transmit head lice. Nits cannot pass on to another person Treatment is recommended only for individuals found with live lice or viable eggs Nits further than ¼ inch from head, are probably hatched and no longer viable The Center for Disease Control published a study in May of 2001 which showed that only 9 of 50 children with nits alone (18%) converted to live lice infestation

14. The “No-Nit” Standard/Policy The American Academy of Pediatrics, Center for Disease Control and Prevention and the National Association of School Nurses no longer support the “no-nit” standard as nits do not transmit head lice

15. Figure C: Live unhatched head louse egg attached to a hair shaft Source: Sally Speare and Rick Speare©, School of Public Health and Tropical Medicine, James Cook University, Townsville, 1998.

16. Prevention: Inspect frequently. Treatment: May include use of lice killing shampoo. Treatment of Belongings: Wash bedding and clothing in hot soapy water. Dry using “high heat” cycle. Bag other items and put outside. Post-treatment Inspection: Inspect individuals up to 10 days following treatment and at 4-6 Weeks 4 Steps to Lice Eradication

17. Head lice are spread by infested people. –Pets cannot get or spread head lice. –Nits cannot spread head lice. Children should not share combs, hats and personal belongings. Frequent inspections are a must. –Search entire head, especially back of head and neck. Inspect hair section by section. Pay attention to your child’s hygiene Prevention of Head Lice

18. Daily Checks of the Hair and Scalp For those treated, hair should be inspected and nits removed once daily for seven to 10 days. Inspect all household members daily for seven to ten days. –Treat anyone who was not treated previously, but is found to be infested through daily inspections.

19. Treating Head Lice Ask your pharmacist for a recommended treatment product Only treat when live head lice are present – head lice products do not prevent head lice. Follow product instructions carefully to avoid re-infestation The products kill the head lice and many eggs, but for most products a second treatment is needed 7 to 10 days after the first treatment to kill any newly-hatched lice before they mature.

20. Treating Head Lice 1. Follow manufacturer’s instructions exactly - Some products require you to shampoo and damp-dry the hair with a towel or blow dryer. - Some products are applied directly to dry hair. 2. Wear plastic or rubber gloves to avoid unnecessary exposure to treatment product. - wrap a towel tightly over the child’s eyes to protect them. 3. Keep your product label!!!!!!!

21. Treating Head Lice Talk to your family doctor: –If a child is under the age of 2 –If you are pregnant or breastfeeding –If a person has a seizure disorder –If a person has broken or infected skin –If lice are on eyebrows, eyelashes or facial hair –If you see live lice 24 – 48 hours after using a lice killing shampoo.

22. General Information on Head Lice Products Follow the directions Timing is important Do not mix products Rinse child’s hair under tap Products should not be used near the eyes, nose, or mouth Wear plastic or rubber gloves Wash your hands after using product Store products away from children Do not apply to open or infected skin

23. Treating Head Lice All nits should be removed after treating with product –Head lice products are not 100 % effective –Removing nits: will reduce hatching of eggs that were not killed with treatment will allow you to notice if a new infestation occurs

24. Treating Head Lice To remove nits: –Part and lift hair to check for nits or lice –Work under a good light (window or lamp) Live lice can be removed with scotch tape wrapped around your finger

25. Treating Head Lice To remove nits –Use fine-tooth nit comb or thumbnail/first finger to grab the nit and slide it off the hair shaft –Place nits in a plastic bag, seal and put in garbage Take frequent breaks, especially with young children. Check and remove nits daily for 2-3 weeks.

26. Treating Head Lice Avoid home remedies – no scientific proof of effectiveness Do not use flea control products, turpentine, paint thinner, etc. If your child has head lice, tell the school/child care facility and child’s close contacts immediately to prevent further spread

27. Housecleaning Wash in hot, soapy water: –Headwear, combs, brushes, pillowcases, towels, bed sheets –Items that cannot be washed should be stored in a sealed plastic bag for 2 -3 days –Excessive housecleaning is unnecessary, but vacuum surfaces where heads have rested –Sofas, car seats, helmets NEVER use insecticide sprays

28. Controlling the spread of Head Lice Discourage head-to-head contact and sharing of hats, scarves, brushes, combs and headwear Check heads of all people in close contact Treat all family members with head lice at the same time Check young school-aged children weekly for head lice; more often if there is an outbreak If head lice continue to return, call your doctor

29. Lice live their entire life cycle on the human body. Lice die within 24 hours after falling off the host. Treatment of classrooms with insecticidal sprays is unnecessary and may be hazardous. Do Not Treat Classrooms

30. Re-infestion Use of ineffective product Did not follow directions Failed to treat the environment

31. Head lice CAN be managed if we all work together to detect and treat these pests!! REMEMBER: Check weekly treat quickly tell the school